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Several interventions provided statistically significant improvements of between 1 and 6 minutes in time to ejaculation( IELT). These include pharmacological interventions( SSRIs and other antidepressants, PDE5 inhibitors, tramadol), topical anaesthetics and behavioural therapies. Many interventions also demonstrated improvements in sexual satisfaction and other outcomes. Behavioural therapy combined with pharmacotherapy was better than behavioural therapy or pharmacotherapy alone. Pharmacological and topical therapies are associated with some AEs. Trial duration was a maximum of 12 weeks for most interventions( 24 weeks for dapoxetine and tramadol). Different interventions have different modes of action and individual patients may have a preference for pharmacological or behavioural interventions, so maintaining a range of options( to be used individually or in combination may remain a useful approach in the treatment of PE.
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